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Diabetes

Carbon Monoxide Link to Diabetes

04/03/2003

Question:

Can inhaling carbon monoxide be a trigger for a child to conceive diabetes, in which the pancreas stops working? Carbon monoxide is a poisonous gas that if a high level has been inhaled the heart or/and lungs can stop functioning. Can you say the same for the pancreas, which is below the heart? Where can I get more information on inhalation of carbon monoxide and trigger effects of diabetes

Answer:

Carbon monoxide is indeed dangerous for people and they can die from inhaling too much carbon monoxide. Major sources of carbon monoxide in our environment includes the exhaust from petroleum- and plant-derived fuels (auto and truck exhaust, improperly vented exhaust from home heating units, industrial plants that use these fuels and have improper exhaust). However, tiny amounts of carbon monoxide may be important as a signaling molecule in some cells of the human body. The major effect of carbon monoxide is to bind to the oxygen carrying site on proteins, including hemoglobin in red blood cells, myoglobin in muscle cells and the enzyme heme oxidase in many different types of cells. This deprives those cells of the ability to deliver oxygen to the body`s tissues. In severe cases, this can cause death. The question is whether there can be more intermediate exposures that cause damage to specific organs without causing death. I think it would be very unlikely that carbon monoxide would cause either type 1 diabetes, the kind in which the insulin-producing cells in the pancreas are destroyed, or type 2 diabetes, the kind in which there are problems with both poor response of tissues to insulin (insulin resistance) and inadequate ability of the pancreatic beta cells to produce enough insulin for the degree of insulin resistance. My major source of information for questions like this is "Pubmed (http://www.ncbi.nlm.nih.gov/PubMed/)." This is a website for accessing the scientific research studies on biology and medicine run by the National Library of Medicine of the National Institutes of Health. It is open to the public. The vast proportion of the information is in technical scientific language so you need to be careful in reading it that you are understanding it properly. When I looked in Pubmed, I found: (1) Reports of two occasions in which people developed diabetes insipidus as a result of carbon monoxide poisoning. Diabetes insipidus is a completely separate disease from diabetes mellitus ("sugar diabetes") and therefore these cases aren`t relevant. 2) Two papers from the 1960`s in which some French doctors looked at alterations in blood sugar regulation in people with carbon monoxide exposure. I didn`t read those studies. But the fact that there have been no papers to suggest an effect of carbon monoxide on diabetes in the intervening 35 years is a good indication that it has not been recognized as a problem. (3) Quite a number of papers in which small amounts of carbon monoxide are used to test lung function in people, including those with diabetes. These really are trying to answer the effects of diabetes on lung function rather than anything having to do with effects of carbon monoxide on either lung function or diabetes. In summary, I can`t say that it is impossible that carbon monoxide can cause type 1 diabetes, but it certainly has not been recognized and it is unlikely that it does. 

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati